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Palifermin for prevention of oral mucositis in allogeneic hematopoietic stem cell transplantation: a single-institution retrospective evaluation

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Abstract

Purpose

The purpose of this study is to assess the impact of palifermin on oral mucositis (OM) and its sequelae in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) who were conditioned with fractionated total body irradiation (FTBI) and etoposide.

Methods

This retrospective chart review study compared the effect of palifermin on the development of OM in patients who received this agent during an allo-HSCT (n = 99) to those who did not (n = 30). The primary end points were severity and duration of OM. Secondary end points included requirements for opioids, total parenteral nutrition (TPN), and intensive oral care; incidence of infection; length of hospital stay; and overall survival.

Results

There was no significant difference in the incidence of all grades of OM, but incidence of severe OM was decreased in palifermin-exposed patients (34 vs 80 %, p < 0.0001). In patients who developed OM (all grades), the median duration of OM was shorter in palifermin-exposed patients (13 vs 18 days, p = 0.0001); there was no difference in the median duration of severe OM. Patients who received palifermin used less opioids and required a shorter duration of intensive oral care. There was no difference in duration of TPN, incidence of infection, length of hospital stay, and overall survival.

Conclusions

Our findings demonstrated a significant benefit with the use of palifermin for allo-HSCT recipients who were conditioned with FTBI and etoposide. Palifermin can potentially improve quality of life for this patient population and reduce complications and resources used during the transplant process. A randomized clinical trial is required to confirm these results.

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Acknowledgments

The authors would like to thank Tanya Paris and Lucy Hallijian for assistance in data collection.

Conflict of interest

This research was not sponsored by any outside organization; thus, the authors do not have a financial relationship with such organization. The authors have full control of all primary data and agree to allow the Journal to review the data if requested.

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Authors and Affiliations

  1. Department of Pharmacy, City of Hope National Medical Center, Duarte, CA, USA

    Diana T. Nguyen & Sepideh Shayani

  2. Department of Biostatistics, City of Hope National Medical Center, Duarte, CA, USA

    Joycelynne Palmer & Andrew Dagis

  3. Division of Hematology/HSCT, City of Hope National Medical Center, Duarte, CA, USA

    Stephen J. Forman & Ricardo Spielberger

  4. Department of Head and Neck Surgery, City of Hope National Medical Center, Duarte, CA, USA

    Joel Epstein

Authors
  1. Diana T. Nguyen
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  2. Sepideh Shayani
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  3. Joycelynne Palmer
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  4. Andrew Dagis
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  5. Stephen J. Forman
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  6. Joel Epstein
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  7. Ricardo Spielberger
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Correspondence to Diana T. Nguyen.

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Nguyen, D.T., Shayani, S., Palmer, J. et al. Palifermin for prevention of oral mucositis in allogeneic hematopoietic stem cell transplantation: a single-institution retrospective evaluation. Support Care Cancer 23, 3141–3147 (2015). https://doi.org/10.1007/s00520-015-2688-7

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  • DOI: https://doi.org/10.1007/s00520-015-2688-7

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